The Olympics and Pelvic Floor: How Pelvic Floor Training is Improving Athletic Performance

Hey there, Bestie! Is it just me, or has the Olympics been absolutely RIVETING this time around?! I seriously have not been able to peel my eyes away from the TV–these athletes are so talented, motivated, and inspiring! Not only that, but I feel like this has been the “Women’s Olympics.” What I mean by this is that it feels like female athletes’ stories have carried the Games this year. This is the first-ever Olympics with gender parity among athletes, with an equal number of female and male athletes competing. Stories of female athletes have dominated the media from Ilona Maher (Rugby Sevens) to Simone Biles (Artistic Gymnastics). It has truly been incredible to watch and it definitely had me thinking “what are these athletes doing for their pelvic floors?” Athletes, in general, are subjected to greater physical forces than the average adult. With constant jumping, pounding, etc, there is more force placed on athletes’ pelvic floors than on the non-athletic person’s. So, is it important for athletes to train their pelvic floors? Let’s talk about it. 

Do Elite Athletes Experience Pelvic Floor Dysfunction?

We’ve talked about this a bit, but elite athletes are highly susceptible to pelvic floor dysfunction (PFD). In fact, engaging in high-impact sports and training for longer hours both seem to be risk factors for urinary incontinence (UI) (1). In an article from 2021, researchers looked at the prevalence of UI in the male and female elite athlete population and found the overall prevalence of UI to affect 33% of the athletes studied (2). When considering males and females separately, 14.7% of the men experienced UI and 45.1% (!!!) of females experienced UI (2). Previous studies on the prevalence of PFD among the general (non-athlete) female population estimate that between 25% and 33% of women experience PFD at some point (3). From these studies it is clear that elite female athletes are potentially experiencing PFD at higher rates than the general public. Because of this, it is paramount for athletes to place emphasis on pelvic floor health when assessing their overall level of fitness. After all, you’re only as strong as your weakest link. 

Something else worth noting is that some research has shown athletes to have stronger pelvic floor muscles (PFMs) than non-athletes (4). Researchers have concluded that physical exercise could contribute to stronger PFMs, but that the PFM strength does not increase proportionally to the high intensity demanded by elite sports (4). Also, let us not forget that pelvic floor strength is not the only component necessary in overall pelvic floor health. The ability of the PFMs to contract and relax completely, contract at the right moment, contract both quickly and powerfully, and maintain a contraction for sustained periods of time all contribute to overall pelvic floor health. Simply stating that athletes have stronger PFMs in general does not indicate that their PFMs are somehow healthier and/or more functional than that of an average person (and in fact, it’s actually the opposite in many cases). 

Does the pelvic floor contribute to athletic performance? 

So, we’ve determined that high level athletes may experience increased levels of PFD and therefore will need to place extra focus on maintaining pelvic floor health–but does the pelvic floor contribute to athletic performance? Can a stronger (healthier) pelvic floor improve elite athletic abilities? 

In an article published last year (2023), authors review current literature in the hopes of answering these very questions. They report that “ a well-conditioned pelvic floor contributes significantly to core stability, balance, and overall muscle function–key elements in optimising sports performance across diverse disciplines,” and even state that “enhanced biomechanics and general stability may result from a pelvic floor workout, which in turn may affect power, agility, and endurance in a variety of athletic pursuits” (5). As we touched on above, PFM strength is not the only factor contributing to overall pelvic floor health. This paper does a good job of emphasizing this point, noting that elite athletes need to have both pelvic floor strength and flexibility (5). 

When trained properly, the healthy pelvic floor can improve balance and stability, core strength, ability to absorb and transfer forces, muscle balance, and biomechanics (5). Further, an emphasis on pelvic floor health as a part of an elite training protocol can also prevent prolapse and other pelvic floor issues such as UI (5). 

Pelvic floor training should be individual and sport-specific. Athletes should work with a pelvic health specialist in addition to their regular coaches. Fortunately, more and more athletes and coaches are recognizing the importance of pelvic floor health when it comes to optimal elite performance. Both male and female athletes can benefit from incorporating pelvic floor activities into their training programs. If you’re an athlete, talk with your coach about how your pelvic floor could be affecting your performance. 

So, what do you think? Do you think some of the Olympians at the Paris 2024 Olympics incorporated pelvic floor training into their training regimens? If you’re an athlete, do you consider your pelvic floor in your training? Let me know and let’s chat soon. 

XOXO,

Your Pelvic Bestie 

References:

1. Culleton-Quinn E, Bø K, Fleming N, Mockler D, Cusack C, Daly D. Elite female athletes' experiences of symptoms of pelvic floor dysfunction: A systematic review. Int Urogynecol J. 2022 Oct;33(10):2681-2711. doi: 10.1007/s00192-022-05302-6. Epub 2022 Aug 30. PMID: 36040507; PMCID: PMC9477953.

2. Rodríguez-López ES, Calvo-Moreno SO, Basas-García Á, Gutierrez-Ortega F, Guodemar-Pérez J, Acevedo-Gómez MB. Prevalence of urinary incontinence among elite athletes of both sexes. J Sci Med Sport. 2021;24(4):338–344. doi: 10.1016/j.jsams.2020.09.017.

3. Kenne, K.A., Wendt, L. & Brooks Jackson, J. Prevalence of pelvic floor disorders in adult women being seen in a primary care setting and associated risk factors. Sci Rep 12, 9878 (2022). https://doi.org/10.1038/s41598-022-13501-w

4. Acevedo-Gómez MB, Rodríguez-López ES, Oliva-Pascual-Vaca Á, Fernández-Rodríguez T, Basas-García Á, Ojedo-Martín C. Is the Elite Female Athlete’s Pelvic Floor Stronger? Journal of Clinical Medicine. 2024; 13(3):908. https://doi.org/10.3390/jcm13030908

5. Khan, Aatika & Khan, Amaan. (2023). Elevating sports performance through pelvic floor training: A review of literature. International Journal of Sports Health and Physical Education. 10.33545/26647559.2023.v5.i2b.91. 

*The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a qualified health provider regarding any questions you may have about a medical condition or health objectives